tci Part B Insider - 2013 Issue 43

Reader Question: Modifier PT Doesn't Apply to Pathology

Question: We billed 88305 and 88342 with modifier PT for a diagnosis of V76.51 and 211.3. The payer denied the 88342 charge. How should we bill this, and should we use a modifier? Also, what date of service should we use if the pathology service was not on the same date as the biopsy? Answer: Assessing what coding issues might have led to the denial is difficult, because you don’t state what specimen your pathologist diagnoses, or what stain the pathologist uses. Based on the diagnosis codes (V76.51, Special screening for malignant neoplasms colon, and...

To read the full article, sign in and subscribe to tci Part B Insider.


Keep pace with evolving Medicare regulations with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI’s Part B Insider will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4800 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles

This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.